The rapidly escalating abuse of methamphetamine (METH) in the United States, places a sense of urgency on understanding the consequences of METH use during pregnancy for the developing child. To our knowledge, IDEAL (Infant Development Environment and Lifestyle) is the only prospective longitudinal NIH study of prenatal Methamphetamine exposure and child outcome. This is a competitive renewal application for the 4-7 year follow-up of the IDEAL cohort. The IDEAL data collection sites are from diverse populations in Iowa, Oklahoma, California, and Hawaii where METH use by pregnant women is prevalent. We have followed 204 Methamphetamine exposed and 208 Comparison children since birth who are now completing assessments at 24 and 30 months. Here, we propose a 4-7 year follow-up, an important age range when executive function neural networks develop and children make the critical transition to school. Our plan is to study a relatively narrow band of executive function domains outcomes supported by the published preclinical and clinical literature and our own preliminary findings. We also plan to study how these executive function domains affect school related academic skills. Our preliminary findings show effects of prenatal Methamphetamine exposure on fetal growth, and on behavior between birth and 3 years on arousal-regulation, attention, inhibitory control, motivation and motor control with some effects due to heavy Methamphetamine exposure. These effects suggest that motor development and precursors of executive function may be affected by prenatal Methamphetamine exposure. We also found effects of psychosocial risk factors including low SES, family conflict, maternal psychiatric status and abuse potential, and out of home placement. In this application, we plan to study the effects of prenatal Methamphetamine exposure on emerging executive function domains including higher order motivation, attention, memory, inhibitory control, visual motor integration, and motor control, and how the effects of prenatal Methamphetamine exposure are affected by psychosocial risk factors and by postnatal passive drug exposure (e.g. smoke).